pulp morphology 2 Flashcards

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1
Q

what are the functions of the odontoblast layer as a permeability barrier?

A

separates pulp and tubular space
regulates movement of material between pulp and tubular ECF
movement can be in either direction

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2
Q

what is exchanges from pulp to dentine?

A

nutrients
secondary and tertiary dentine
tubular nerves i.e potassium

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3
Q

what is exchanges from dentine to pulp?

A

medicaments applied to dentine

diffusion of toxins from bacteria or components of filling materials

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4
Q

what are pulp nerves branches of?

A

alveolar nerves

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5
Q

where do the nerves enter the pulp?

A

neurovascular bundles enter pulp via apical foramen

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6
Q

what is the journey of the pulp nerbes?

A

pass along root canal in centre of pulp towards coronal pulp chamber, branch out in sub-odontoblastic layer
(rashow’s plexus)
terminal branches enter odontoblast layer, some enter dentinal tubules

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7
Q

describe the innervation of dentine

A

40% of nerves enter tubules
15% tubular innervation in coronal dentine
4% root dentine
most axons end in pulp-predentine region so don’t enter tubules

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8
Q

what is the function of the hydrodynamic mechanism?

A

activating intradental sensory nerves

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9
Q

what stimulus can start the hydrodynamic mechanism?

A

thermal, mechanical, evaporative, chemical

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10
Q

what does the hydrodynamic mechanism stimulus act on?

A

exposed dentine; open tubules

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11
Q

describe the hydrodynamic mechanism

A

the stimulus on exposed dentine increases rate of dentinal fluid flow

generating AP’s in intradental nerves

AP’s pass to brain to cause pain

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12
Q

what are the effects of outward fluid flow?

A
cooling
drying
evaporating
hypertonic solutions
decreased hydrostatic pressure
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13
Q

what are the effects of inwards fluid flow?

A

heating
mechanical
increased hydrostatic pressure

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14
Q

which direction of fluid flow is more effective in activating intradental nerves?

A

outwards (away from pulp)

as rapid, outward flow stretches the nerves

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15
Q

which stimuli bypass the hydrodynamic mechanism and act directly on intradental nerves

A

intense heat
intense cooling
electrical current
pain-producing chemicals

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16
Q

why can high fillings cause dentinal pain?

A

force distorts the dentine and alters tubular fluid flow

17
Q

what types of nerve fibres are in intradental nerves?

A
A beta, A 
large & small myelinated
normal dentinal sensitivity
activated by hydrodynamic stimuli
C
unmyelinated
activated directly by stimuli
intense stimulation
pulp inflammation pain
18
Q

describe pulp b.v

A

rich vascular bed

stops short of dentine

19
Q

how is pulp blood flow controlled?

A
local factors eg metabolites
nerves
-sympathetic
-somatic afferents
circulating hormones
drugs eg local anaesthetic
20
Q

why can use of an uncooled bur cause irreversible damage to the pulp?

A

heat

21
Q

what are the functions of pulp nerves?

A
sensory- mediate pain
control pulp b.v
-sympathetic vasoconstrict
-afferents vasodilate
promote neurogenic inflammation
promote dentine formation
facilitate immune response
22
Q

describe immediate dentine-pulp response to injury

A

nociceptor activation

-pain

23
Q

describe 1 min dentine-pulp response to injury

A

early inflammatory response
kinins, prostaglandins, neuropeptides
vasodilation

24
Q

describe 10 mins dentine-pulp response to injury

A

nociceptor sensitisation
extravasation of fluid, oedema
polymorph migration

25
Q

describe 100 mins dentine-pulp response to injury

A

enzyme activation; nerve growth factor

monocyte presense

26
Q

describe 1 day dentine-pulp response to injury

A

nerve sprouting (NGF)
increased axonal transport
altered excitability of CNS synapses

27
Q

describe 1 week dentine-pulp response to injury

A

repair

tertiary dentine formation

28
Q

when does completion of repair and recovery from dentine-pulp response occur?

A

variable

29
Q

what is pulpitis?

A

acute inflammation in the dental pulp is similar to that in other tissues
but pulp cant swell as confines to pulp chamber
oedema causes increased pulp pressure
variable effects on blood flow and nerve excitability